腹部手术期间保温措施对老年患者凝血功能的影响

目的探讨腹部手术期间保温措施对老年腹部手术患者凝血功能的影响。方法将2007年9月-2008年8月在普外科施行腹部手术的60例老年患者随机分为观察组和对照组各30例。对照组接受常规的治疗和护理，观察组在对照组的基础上加以一系列体温保护措施。比较2组患者术前术后体温、血小板计数（PLT）、凝血活酶原时间（PT）、活化部分凝血活酶时间（APIT）、凝血酶时间（TT）、纤维蛋白原（Fbg）定量的变化及术中出血量。进行t检验及X^2检验。结果观察组患者围手术期体温无显著变化，低体温发生率显著低于对照组；各项凝血功能指标亦显著优于对照组。结论老年患者腹部手术期间发生的轻度低体温会影响患者的凝血功能，增加手术出血量，积极的保温措施可有效维持患者体温恒定。

Influence of insulation measures on blood coagulation function during laparotomy in the aged patients

Objective To explore the effects of insulation measures on blood coagulation during laparotomy in the aged patients. Methods Sixty patients were randomly divided into the experimental group and the control group with 30 cases in each group from September 2007 to August 2008. The experi- mental group received a series of insulation measures based on general perioperative nursing care, which was given to the control group. Patients＇ temperature, platelet count （PLT）, prothrombin time （ PT ）, acti- vated partial thromboplastin time （ APTT）, thrombin time （ TT ）,fibrinogen （Fbg） were measured and these preand postoperative values together with blood loss during operation were compared between two groups. Results No significant change was seen in perioperative body temperature in the experimental group, the incidence rate of hypothermia was lower,the change in coagulation index was better than that of the control group. Conclusions These results suggested that mild hypothermia could influence aged patients＇ blood coagulation function and increase blood loss during laparotomy. Active insulation measures can maintain the stability of patients＂ temperature.